HomeMy WebLinkAboutStreet Cut Permit 44 Goose Nest 800062 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 05/08/08
GIS ID: 51900044
MUNIS APPLICATION# 200800627 FEE: 25.00
EXPIRATION DATE: 05/08/09
APPLICANT
NAME: QUALITY PAVING CO LOCATION
AbISS 44 LAEWQOD/GOOSE NEST
ADDRESS: 194 S. MAIN STREET OWNER QUALITY PAVING CO
EAST WINDSOR,CT bog8
3 ;5 MAIN STREET
PHONE 860-523-4182 EASE WINDSOR, CT 06088
WORK DESCRIPTION: DRIVEWAY
APP
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...:;>,.'. "b� vT €MQI1I�`fi3OR:B�OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY B EI SBS I 1Ci7I 4 #E:T } N I:?R MAINTENANCE
CONNECTION WITH THIS PERMIT AND THE bPL „I ' i OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TOWN OF S IC I�IT: II< rS., WILL ABIDE BY THE RULES AND REGULATIONS
��[//y/�/� �'REyB ' U 'pE :IvIIT MANUAL.
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ISSUED BY DATE INSPE'CTED INSPECTED BY
5/8/200811:38AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: gWbo'a- CONTRACTOR:_ ?
LOCATION: y y
TYPE OF WORK:_
DATE INSP NEEDED: DATE INSP:-j,dt �-�--
INSPECTED BY:_��_
WORK IN
PROGRESS: no Z_
AS-BUILT:
INPUT: DATE: j 00- d
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT 8 001)0
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE-$25.00
Name of firm v Phone No. S
Address of Firm
Location of proposed work_
Describe fully nature of permit requested
Starting date
Approx.time for completion_ - o - �>Q
Call Before You Dig No.2 $k q L Cr;Z Traffic Services Control No.
Show sketch of Proposed worts or fumish
two copies of separate drawing Indicate North This section to be filled out by
Town of South'Windsor
Pavement Cut
No.cuts
Est.'Size of Penn.PatdXs)
rI - Est.Pvt.Thickness in.
Est.Unit Price$
Amt.of Deposit$
Total Due$ by
_ 1 ( )Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
1 I Final Billing
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contactina
the Police Dept.and C.B.Y.D. Da
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SO WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION Ii THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS UTL TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: � - � b �
L f _
Title: " �� l P 5►VLe�,;�s Driver's License#: o 7
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES